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Objective:To investigate the feasibility and safety of suprapubic bladder puncture and gland fixation in transurethral enucleation of the prostate.Methods:The clinical data of 15 patients with benign prostatic hyperplasia admitted to the First Affiliated Hospital of Guangxi Medical University from January 2020 to June 2020 were retrospectively analyzed. The age was (70.27±5.35) years old, preoperative serum prostate-specific antigen (PSA) level was (3.03±1.37) ng/ml, preoperative total prostate weight was 80.3(70.49, 96.78)g, preoperative postvoid residual urine volume(PVR)was 80 (55, 108)ml, and the maximum urine flow rate (Q max) was (6.13±2.25) ml/s. The international prostate symptom score(IPSS) was 25(22, 27), quality of life (QOL)score was 5(5, 6), international erectile function index-5 (IIEF-5) score was (15.38±5.10). All 15 patients underwent conventional transurethral plasma enucleation of prostate by using the three-lobe method, and the enucleated gland was pushed into the bladder completely. Then a laparoscopic pneumoperitoneum needle was used to perform suprappubic cystipuncture, and ureteral grasping forceps were inserted through the outer sheath. The forceps were used to fix the enencied gland. A rapid harvesting electric resection was performed in the broad space of the bladder, and the Ellick was rinsed to remove the tissue fragments. Surgical indicators and complications were recorded. The improvement of subjective score (IPSS, QOL, IIEF-5) and objective index (Q max, PVR) was compared between preoperative and postoperative. Results:All the 15 operations were completed successfully and there were no complications such as blood transfusion, capsule perforation, transurethral resection syndrome, bladder injury, bladder puncture site laceration and bleeding. The weight of resected prostate tissue was 44(40, 60)g, with blood loss (79.20±18.93)ml.The time of enucleation operation was (54.13±10.88)min, with harvest cutting time (14.67±2.50)min, evisceration efficiency (0.89±0.08)g/min, harvesting efficiency (3.26±0.36)g/min, bladder irrigation time (2.47±0.52) d. The time of indwelling catheter was (3.73±0.80)d.The postoperative hospital stay was (4.40±0.91) d. Temporary urinary incontinence occurred in 1 case after operation. All patients were followed up for 6 months after operation. The IPSS score was 3(2, 3), QOL score was 0(0, 1), IIEF-5 score was (20.12±2.30), Q maxwas (21.80±2.14) ml/s and PVR was 10(5, 15)ml, which were all significantly different compared with those before surgery ( P<0.05). The symptoms of the patients were significantly improved. Conclusions:Transurethral plasma enucleation of prostate combined with suprapubic bladder puncture and fixed gland is effective in the treatment of benign prostatic hyperplasia. The subjective symptoms and objective examination of patients have been significantly improved, and no adverse operation-related complications have occurred. It is a suitable method for enucleation of prostate in units which are not equipped with transurethral tissue planer.
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Objective To compare the serum index after colonoscopy high-frequency electric snare combined with nylon cord ligation and high-frequency electric resection in treating broad pedicle polyps. Methods 70 cases of broad pedicle polyps patients from July 2012 to May 2016 were chosen as research object. The operation methods and laboratory examination results of all the patients were reviewed. All patients were divided into observation group (n = 37) and control group (n = 33). Patients in observation group were treated by colonoscopy high-frequency electric snare combined with nylon loop ligation, while patients in control group were treated by high-frequency electric resection only. The blood loss and related indexes of the two groups were recorded. Before and after operation, stress hormones and acute phase proteins in serum was determined. Results Intraoperative blood loss of observation group was less than that in control group, postoperative hemoglobin levels was higher than that in control group, postoperative early bleeding rate, postoperative delayed bleeding rate of observation group were lower than that in control group (P < 0.05); 1 hour after surgery, Cor, ACTH, AT II, NE, CRP, SAA, AAT in serum were lower than those in control group (P < 0.05). Conclusion Through colonoscopy high-frequency electric snare combined with nylon cord ligation can reduce bleeding during and after surgery, relieve stress and inflammation.
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Objective To discuss the efficacy and safety of sterile repositionable hemostasis clipping device in combination with high frequency electric snare in polypectomy of colorectal polyps with wide and long peduncle. Methods From January 2014 to December 2015, 21 cases of colorectal polyps with wide and long peduncle (diameter greater than 2 cm) in endoscopic treatment under electronic colonoscopy. We used 1 ~ 2 hemostatic clips to clip colorectal polyps roots, then used electric resection with high frequency electric snare electric coagulation. Postoperative bleeding, perforation were observed follow-up. Results 24 polyps in 21 cases were removed one-time successfully. Stump errhysis in 1 case, hot biopsy forceps is given to deal with local wound followed by Olympus Clip HX-610-135L EZ titanium clip. There was no complication such as bleeding and perforation in 3 to 6 months after the operation. In the colonoscopy examination, recurrence of polyps were not found in the original polyp resection site. Conclusion Sterile repositionable hemostasis clipping device in combination with high frequency electric snare in polypectomy of colorectal polyps with wide and long peduncle is safe and effective, without bleeding or perforation.
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OBJECTIVE:To observe the efficacy and safety of carboprost and Foley catheter for the expand cervix before hys-teroscopic electric resection. METHODS:80 patients with hysteroscopic operation were randomly divided into research group and control group. Research group was placed inside the vagina carboprost 1 mg 30 minutes before operation;control group was placed inside the Foley catheter 12 hour before operation. The relaxation degree of the cervix,average operative time,preoperative pain, postoperative morbidity and incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differ-ences in the relaxation degree of the cervix,postoperative morbidity and incidence of adverse reactions between 2 groups(P>0.05). The average operative time and preoperative pain in research group were significantly better than control group,the differ-ence was statistically significant(P<0.05). CONCLUSIONS:Carboprost and Foley catheter have good efficacy and safety for ex-pand cervix before hysteroscopic electric resection,however,carboprost is better than Foley catheter in terms of average operative time and preoperative pain.
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Objective To investigate the use of cystoscopy in the diagnosis and treatment of glandular cystitis. Methods A total of 38 cases of glandular cystitis was pathologically diagnosed under cystoscopy.The patients were treated by transurethral electric resection.After surgery a chemotherapy with mitomycin-c bladder irrigation was given once weekly for 8 times and then once monthly for 10 times.During the follow-up a cystoscopy was periodically performed and biopsy samples were pathologically examined with all the cases.Results The follow-up checkups were made for 6~12 months in 38 cases.Of the 38 cases,29 cases were cured(with transitional cell surface covering the bladder musoca gradually),5 were symptomatically relieved,and 4 were found relapsed. Conclusions Cystoscopy can offer valuable help for the diagnosis of glandular cystitis.Treatments with transurethral electric resection and mitomycin-c bladder irrigation are effective for glandular cystitis.